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The Glymphatic System in Central Nervous System Health and Disease: Past, Present, and Future
The central nervous system (CNS) is unique in being the only organ system lacking lymphatic vessels to assist in the removal of interstitial metabolic waste products. Recent work has led to the discovery of the glymphatic system, a glial-dependent perivascular network that subserves a pseudolymphati...
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Published in: | Annual review of pathology 2018-01, Vol.13 (1), p.379-394 |
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description | The central nervous system (CNS) is unique in being the only organ system lacking lymphatic vessels to assist in the removal of interstitial metabolic waste products. Recent work has led to the discovery of the glymphatic system, a glial-dependent perivascular network that subserves a pseudolymphatic function in the brain. Within the glymphatic pathway, cerebrospinal fluid (CSF) enters the brain via periarterial spaces, passes into the interstitium via perivascular astrocytic aquaporin-4, and then drives the perivenous drainage of interstitial fluid (ISF) and its solute. Here, we review the role of the glymphatic pathway in CNS physiology, the factors known to regulate glymphatic flow, and the pathologic processes in which a breakdown of glymphatic CSF-ISF exchange has been implicated in disease initiation and progression. Important areas of future research, including manipulation of glymphatic activity aiming to improve waste clearance and therapeutic agent delivery, are also discussed. |
doi_str_mv | 10.1146/annurev-pathol-051217-111018 |
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Important areas of future research, including manipulation of glymphatic activity aiming to improve waste clearance and therapeutic agent delivery, are also discussed.</description><subject>amyloid-β</subject><subject>aquaporin-4</subject><subject>astrocyte</subject><subject>cerebrospinal fluid</subject><subject>glymphatic</subject><subject>perivascular space</subject><issn>1553-4006</issn><issn>1553-4014</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqVkE1LxDAQhoMofv8FycGDB6szbdIP8SLrxwqLCupRwtidspW2uyapsv_eaFfvnhKY531neIQ4RDhBVOkpdV1v-SNakJ_Nmwg0xphFiAiYr4lt1DqJFKBa__tDuiV2nHsDUEma55tiKy6w0CG5LV6eZixvmmW7mJGvS_m4dJ5bWXdyxJ231Mg7th_z3v1OxkyNn0nqpvKydkyOz-QDOX8sHyy7kDn-mV33Ply5JzYqahzvr95d8Xx99TQaR5P7m9vRxSQiDeijGBRUGWKWxkmcpVNCrEgr9QoZFJQiZFolTHmSAiGVJRUMWFSaAw86p2RXHA29Czt_79l509au5KahjsPtBosMM4RUFQE9H9DSzp2zXJmFrVuyS4NgvgWblWAzCDaDYDMIDvGD1ab-teXpX_jXaAAuBuC7hppQVPOn-9-SL2JRkG0</recordid><startdate>20180124</startdate><enddate>20180124</enddate><creator>Plog, Benjamin A</creator><creator>Nedergaard, Maiken</creator><general>Annual Reviews</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180124</creationdate><title>The Glymphatic System in Central Nervous System Health and Disease: Past, Present, and Future</title><author>Plog, Benjamin A ; Nedergaard, Maiken</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a501t-2040f7117623276da11fa544b0709a6107543ea8360a1acca9e019f5e623058a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>amyloid-β</topic><topic>aquaporin-4</topic><topic>astrocyte</topic><topic>cerebrospinal fluid</topic><topic>glymphatic</topic><topic>perivascular space</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Plog, Benjamin A</creatorcontrib><creatorcontrib>Nedergaard, Maiken</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annual review of pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Plog, Benjamin A</au><au>Nedergaard, Maiken</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Glymphatic System in Central Nervous System Health and Disease: Past, Present, and Future</atitle><jtitle>Annual review of pathology</jtitle><addtitle>Annu Rev Pathol</addtitle><date>2018-01-24</date><risdate>2018</risdate><volume>13</volume><issue>1</issue><spage>379</spage><epage>394</epage><pages>379-394</pages><issn>1553-4006</issn><eissn>1553-4014</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-3</notes><notes>content type line 23</notes><notes>ObjectType-Review-2</notes><abstract>The central nervous system (CNS) is unique in being the only organ system lacking lymphatic vessels to assist in the removal of interstitial metabolic waste products. 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subjects | amyloid-β aquaporin-4 astrocyte cerebrospinal fluid glymphatic perivascular space |
title | The Glymphatic System in Central Nervous System Health and Disease: Past, Present, and Future |
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